Desmopressin

Desmopressin (DDAVP®, Stimate®, Minrin®) is a synthetic drug that mimics the action of antidiuretic hormone. It may be taken nasally or intravenously.

Chemistry

Desmopressin is a modified form of the hormal human vasopressin, which 1-desamino-8-D-arginine vasopressin. Vasopressin is a an octapeptide (a chain of eight amino acids). In desmopressin, the first amino acid has been deaminated, and the arginine at the eighth position is in the levo rather than the normal dextro form (see stereochemistry for elaboration on the terms).

Method of action

Desmopressin binds to V2 receptor in renal collecting ducts increasing water resorption. It also stimulates release of factor VIII from platelets due to stimulation of the V1a receptor. Desmopressin is degraded much slower than recombinant vasopressin, and requires less frequent administration. In addition, it has no influence on blood pressure, while vasopressin may cause arterial hypertension.

Uses

Desmopressin is used to reduce urine production in central diabetes insipidus patients and to promote the production von Willebrand factor and factor VIII in patients with coagulation disorders including type I von Willebrand disease, hemophilia A, and thrombocytopenia. It may also be prescribed to reduce frequent bedwetting episodes in children.

Side effects

Related topics

References

  • Leissinger C, Becton D, Cornell C Jr, Cox Gill J. High-dose DDAVP intranasal spray (Stimate) for the prevention and treatment of bleeding in patients with mild haemophilia A, mild or moderate type 1 von Willebrand disease and symptomatic carriers of haemophilia A. Haemophilia 2001;7:258-66. PMID 11380629.

 

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